Model Standards impact on local health department performance in California

An evaluation of a state-local negotiation process to implement Model Standards in 18 California local health departments was conducted during 1985-87. Model Standards specific to California were developed by state and local public health officials for seven programs. Nine counties participated in state-local negotiations to set performance standards in these seven programs. During the two-year effort, greater use of Model Standards and more improvement in local program performance occurred in local health departments that participated in the state-local negotiation process. The use of Model Standards appeared to contribute to establishing program priorities, emphasizing the measurement of outcomes, improving data management systems, and evaluating the current performance of programs. While this state-local negotiation process is suggested as the preferred approach to encouraging the use of Model Standards in local health departments, it must be recognized that this process requires time and commitment of resources from both the state and local levels.